Powell, Suzanne M
Powell, Suzanne M is an individual health care provider with primary practice located at 12A Ledgebrook Dr , Mansfield Center CT 06250-1690. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Powell, Suzanne M can be contacted via phone (860) 423-2960.Contact Information
Primary practice address
12A Ledgebrook Dr
Mansfield Center CT 06250-1690
Phone: (860) 423-2960
Fax: (860) 423-3719
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 042791 | Connecticut |
Profile Details
| NPI number | 1013905363 |
|---|---|
| LBN Legal business name | Powell, Suzanne M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2005 |
| Last updated | May 4th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013905363 | NPPES |
| Connecticut | MEDICAID | 001427914 |
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